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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2017

01-09-2017 | Urologic Oncology

Oncologic Outcome of Metastasectomy for Urothelial Carcinoma: Who Is the Best Candidate?

Authors: Tohru Nakagawa, MD, PhD, Satoru Taguchi, MD, Atsushi Kanatani, MD, PhD, Taketo Kawai, MD, PhD, Masaomi Ikeda, MD, PhD, Shinji Urakami, MD, PhD, Akihiko Matsumoto, MD, PhD, Yoshimitsu Komemushi, MD, Jimpei Miyakawa, MD, Daisuke Yamada, MD, PhD, Motofumi Suzuki, MD, PhD, Yutaka Enomoto, MD, PhD, Hiroaki Nishimatsu, MD, PhD, Yasushi Kondo, MD, PhD, Yasushi Nagase, MD, Yoshikazu Hirano, MD, PhD, Toshikazu Okaneya, MD, PhD, Yoshinori Tanaka, MD, PhD, Hideyo Miyazaki, MD, PhD, Tetsuya Fujimura, MD, PhD, Hiroshi Fukuhara, MD, PhD, Haruki Kume, MD, PhD, Yasuhiko Igawa, MD, PhD, Yukio Homma, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2017

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Abstract

Background

Resection of metastatic lesions (metastasectomy) is performed for highly selected patients with metastatic urothelial carcinoma (mUC). This study aimed to identify the clinicopathologic factors associated with oncologic outcome for patients who underwent metastasectomy for mUC.

Methods

This analysis included 37 UC patients who underwent metastasectomy with curative intent at nine Japanese hospitals. The primary end point was cancer-specific survival. The Kaplan–Meier method with the log-rank test and the multivariable Cox proportional hazards model addressed the relationship between clinical characteristics and survival.

Results

Metastasectomy was performed for pulmonary (n = 23), nodal (n = 7), and other (n = 7) metastases. The median survival time was 35.4 months (interquartile range [IQR] 15.5, not reached) from the detection of metastasis and 34.3 months (IQR 13.1, not reached) from metastasectomy. The 5-year cancer-specific survival rate after detection of metastasis was 39.7%. In the multivariate analysis, the time from primary surgery to detection of metastasis (time-to-recurrence [TTR]) of 15 months or longer (hazard ratio [HR] 0.23; p = 0.0063), no symptoms of recurrence (HR 0.23; p = 0.0126), and serum C-reactive protein (CRP) levels lower than than 0.5 mg/dl (HR 0.24; p = 0.0052) were significantly associated with better survival.

Conclusions

Long-term survival could be achieved for some patients with mUC who underwent metastasectomy. Lung and lymph nodes were predominant sites for metastasectomy. Symptoms, TTR, and CRP value were identified as associated with survival and should be taken into account when metastasectomy is considered.
Appendix
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Metadata
Title
Oncologic Outcome of Metastasectomy for Urothelial Carcinoma: Who Is the Best Candidate?
Authors
Tohru Nakagawa, MD, PhD
Satoru Taguchi, MD
Atsushi Kanatani, MD, PhD
Taketo Kawai, MD, PhD
Masaomi Ikeda, MD, PhD
Shinji Urakami, MD, PhD
Akihiko Matsumoto, MD, PhD
Yoshimitsu Komemushi, MD
Jimpei Miyakawa, MD
Daisuke Yamada, MD, PhD
Motofumi Suzuki, MD, PhD
Yutaka Enomoto, MD, PhD
Hiroaki Nishimatsu, MD, PhD
Yasushi Kondo, MD, PhD
Yasushi Nagase, MD
Yoshikazu Hirano, MD, PhD
Toshikazu Okaneya, MD, PhD
Yoshinori Tanaka, MD, PhD
Hideyo Miyazaki, MD, PhD
Tetsuya Fujimura, MD, PhD
Hiroshi Fukuhara, MD, PhD
Haruki Kume, MD, PhD
Yasuhiko Igawa, MD, PhD
Yukio Homma, MD, PhD
Publication date
01-09-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5970-8

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